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Can't even find out what stuff costs beforehand either. I had to get a blood test. I had gotten burned before where my insurance said they covered a physical, b

Can't even find out what stuff costs beforehand either. I had to get a blood test. I had gotten burned before where my insurance said they covered a physical, but it turns out their definition of a physical didn't include the doctor's definition, which included blood tests. So before I had my blood drawn, I asked them to tell me what the tests would cost if my insurance didn't cover it. "It depends on how it's coded," they said. So I asked them to check how it was coded and tell me what the "code" cost. They looked it up. It was coded wrong, apparently. They would have to talk to the doctor and couldn't, so I would need to make a return appointment, or I could just let them draw my blood. Still don't know what the coding was or was supposed to be, or really what that even means. I just needed to get life insurance and get back to work. I found out the price once I was billed for it.

deleted 8y ago
[deleted]
acdha 8y ago
I think of this every time someone acts like U.S. healthcare is a market in any positive sense: our son had his first birthday before we got the last hospital bill (they were hoping we’d gift them money beyond their negotiated rate with our insurance company) while nobody I know from another country has ever had any experience with that.
- trashface 8y ago
  That may be so-called "balance billing". It is illegal in some states.
roenxi 8y ago
'You should know the price before you agree to buy the product' seems like such an innocuous principle. Why isn't their broad-based support of it for medical care? If you need emergency care then sure, there isn't time. The vast majority of interactions with the medical system aren't that type of emergency though. People have time to choose the better of two options. They can't decide on better if they don't know the price.
- Delfino 8y ago
  Yeah, this has baffled me before. I remember learning in my Family & Consumer Sciences class about the importance of being an informed consumer. Then, in college I had to get a dental procedure done and I called around to try to find out the price from different dentists and no one could give me any actual numbers. I ultimately just had to pick a place based on reviews and found out the price after the fact with no knowledge of how it compared t other places.
  - bzbarsky 8y ago
    That's odd. Dentists, unlike doctors, will in my experience just give you a price if you ask for it... Maybe this varies state to state?
    - fre3k 8y ago
      They used to but it's dwindling. A friend of mine is a dentist and he said when he first graduated from dental school some 15 years ago, his father and his practice dealt directly with the patient and had a list of all of their prices on their website and in their office. As customers increasingly wanted to have their insurance cover dental they had fewer and fewer people paying out of pocket and going through insurance. So prices went up due to increased complexity of the business.
      - enonevets 8y ago
        At my dental office, they can tell you the total cost without insurance which is the maximum they would charge for any procedure. If you paid in cash in full, they would do a discount (for non-insured). For those insured, it depended on the insurance you had but they would give you a rough estimate based on the plan you had (mostly because they can’t be 100% certain what the insurance will cover down to the exact dollar amount. In my experience the estimate is often off but close enough that I am not worried I’d owe an insane amount afterwards.
  - AlexTWithBeard 8y ago
henrikschroder 8y ago
I was at the dentist today because I managed to chip a tooth yesterday, and needed it fixed. Before the procedure, they asked if I wanted an estimate, I said sure, and got one in a minute. The dental industry works the same as the medical, I have a half-useless insurance that covers too little, and out-of-pocket expenses are always higher than you expect. But if they can do estimates before a procedure, why the hell can't the medical industry do the same?
- debatem1 8y ago
  Just to put my cautionary experience in on that, I woke up after some oral surgery about ten years ago to find out that my estimate was worthless and the actual cost was twice what was estimated. I was fortunate enough to have recently gotten a good paying job and could cover it, but it was certainly a shock.
- phonebanshee 8y ago
  Dental insurance isn't insurance in the normal sense. It's more a way to prepay dental expenses with pre-tax dollars.
- addicted 8y ago
  In the US those estimates can often be wrong.
- TallGuyShort 8y ago
  Yeah I was able to get an estimate on the birth of my child, too. But then lawyers had to get involved between me and Banner Health a year later, over a bill from an anesthesiologist they said didn't exist, with contact information at which no one said I owed any money, that was never billed to my insurance company, for an epidural that ended up being done quite poorly. In the end it was considered to be my responsibility because of a paper my wife signed while in hard labor agreeing to pay the bill. Fuck the whole industry. That's not even my worst experience - just the most recent. I basically don't visit doctors or dentists anymore because the biggest health threat I see in my life is the massive surge of blood pressure I get at the mere mention of insurance companies.
mrhappyunhappy 8y ago
Just had all the blood tests done here in Japan. Walked out paying a total of $80. Had I been employed by a Japanese employer, it would have been free. They told me the fee up front.
jccalhoun 8y ago
The billing for health care in the USA is also rediculous. Last week I got a bill from the doctor's office for a visit back in November that my insurance company decided not to pay. What other business takes 4+months to send a bill?
- lost_my_pwd 8y ago
  Oh it can get even more ridiculous... yesterday I got yet another $300 bill for an ER visit from October 2017. Now I have figure out whether it will cost me more in lost billable hours than to just pay this bill, knowing that contacting my $1700/mo insurance company to help sort things out will prove to be fruitless.
- mywittyname 8y ago
  My partner works for a large hospital network dealing with insurance payments. Their department is not even able to figure out how much bills "should be," which prevents them from being able to prioritize their work based on total costs. When the process is voodoo for the people who actually deal with insurance payments, normal people stand zero chance because it's unlikely you'll ever find a person to talk to who can find this information out.
tedmiston 8y ago
I agree this is all a huge pain. I've been burned on "this test cost you x because of the facility it was done in and if you had gone to one of our partner labs (which you'd have no way of knowing without calling us), you could have had it done in <dedicated, partner lab> for 1/4x". I recently learned that there are 2 different codes involved and that it's the combination that matters. 1. The diagnostic code - the reason why you need that test 2. The procedure code - what the test is My insurance tells me that their coverage (as in whether they cover a service or do not) is different for the same procedure code with a different diagnostic code. I'm not sure if that implies that their coverage price for the same procedure code also varies by the diagnostic code. Your doctor can give you both codes for the test they're prescribing. In theory, your insurance company can tell you what they'll pay for the combination, and then you can contact each lab / hospital / service provider to get an estimate for what they'd bill. It's unclear how much recourse you have if the bill turns out to be significantly different than the estimate… that is once the bill actually arrives, sometimes 30–60 days later. I'm not sure if the service provider's bill varies for the same procedure code with a different diagnostic code. Admittedly this is all a huge pain and with my insurance company at least, cannot be done online, you must call and wait. It's all such a time sink that I usually just get the service done upfront and hope. Sometimes the end consumer cost is practically free, sometimes it's hundreds of dollars or more. It should be more feasible for us to know a rough estimate for a procedure across providers upfront.

deleted 8y ago

[deleted]

acdha 8y ago

I think of this every time someone acts like U.S. healthcare is a market in any positive sense: our son had his first birthday before we got the last hospital bill (they were hoping we’d gift them money beyond their negotiated rate with our insurance company) while nobody I know from another country has ever had any experience with that.

trashface 8y ago
That may be so-called "balance billing". It is illegal in some states.

roenxi 8y ago

'You should know the price before you agree to buy the product' seems like such an innocuous principle. Why isn't their broad-based support of it for medical care? If you need emergency care then sure, there isn't time. The vast majority of interactions with the medical system aren't that type of emergency though. People have time to choose the better of two options. They can't decide on better if they don't know the price.

Delfino 8y ago
Yeah, this has baffled me before. I remember learning in my Family & Consumer Sciences class about the importance of being an informed consumer. Then, in college I had to get a dental procedure done and I called around to try to find out the price from different dentists and no one could give me any actual numbers. I ultimately just had to pick a place based on reviews and found out the price after the fact with no knowledge of how it compared t other places.
- bzbarsky 8y ago
  That's odd. Dentists, unlike doctors, will in my experience just give you a price if you ask for it... Maybe this varies state to state?
  - fre3k 8y ago
    They used to but it's dwindling. A friend of mine is a dentist and he said when he first graduated from dental school some 15 years ago, his father and his practice dealt directly with the patient and had a list of all of their prices on their website and in their office. As customers increasingly wanted to have their insurance cover dental they had fewer and fewer people paying out of pocket and going through insurance. So prices went up due to increased complexity of the business.
    - enonevets 8y ago
      At my dental office, they can tell you the total cost without insurance which is the maximum they would charge for any procedure. If you paid in cash in full, they would do a discount (for non-insured). For those insured, it depended on the insurance you had but they would give you a rough estimate based on the plan you had (mostly because they can’t be 100% certain what the insurance will cover down to the exact dollar amount. In my experience the estimate is often off but close enough that I am not worried I’d owe an insane amount afterwards.
- AlexTWithBeard 8y ago

henrikschroder 8y ago

I was at the dentist today because I managed to chip a tooth yesterday, and needed it fixed. Before the procedure, they asked if I wanted an estimate, I said sure, and got one in a minute. The dental industry works the same as the medical, I have a half-useless insurance that covers too little, and out-of-pocket expenses are always higher than you expect. But if they can do estimates before a procedure, why the hell can't the medical industry do the same?

debatem1 8y ago
Just to put my cautionary experience in on that, I woke up after some oral surgery about ten years ago to find out that my estimate was worthless and the actual cost was twice what was estimated. I was fortunate enough to have recently gotten a good paying job and could cover it, but it was certainly a shock.
phonebanshee 8y ago
Dental insurance isn't insurance in the normal sense. It's more a way to prepay dental expenses with pre-tax dollars.
addicted 8y ago
In the US those estimates can often be wrong.
TallGuyShort 8y ago
Yeah I was able to get an estimate on the birth of my child, too. But then lawyers had to get involved between me and Banner Health a year later, over a bill from an anesthesiologist they said didn't exist, with contact information at which no one said I owed any money, that was never billed to my insurance company, for an epidural that ended up being done quite poorly. In the end it was considered to be my responsibility because of a paper my wife signed while in hard labor agreeing to pay the bill. Fuck the whole industry. That's not even my worst experience - just the most recent. I basically don't visit doctors or dentists anymore because the biggest health threat I see in my life is the massive surge of blood pressure I get at the mere mention of insurance companies.

mrhappyunhappy 8y ago

Just had all the blood tests done here in Japan. Walked out paying a total of $80. Had I been employed by a Japanese employer, it would have been free. They told me the fee up front.

jccalhoun 8y ago

The billing for health care in the USA is also rediculous. Last week I got a bill from the doctor's office for a visit back in November that my insurance company decided not to pay. What other business takes 4+months to send a bill?

lost_my_pwd 8y ago
Oh it can get even more ridiculous... yesterday I got yet another $300 bill for an ER visit from October 2017. Now I have figure out whether it will cost me more in lost billable hours than to just pay this bill, knowing that contacting my $1700/mo insurance company to help sort things out will prove to be fruitless.
mywittyname 8y ago
My partner works for a large hospital network dealing with insurance payments. Their department is not even able to figure out how much bills "should be," which prevents them from being able to prioritize their work based on total costs. When the process is voodoo for the people who actually deal with insurance payments, normal people stand zero chance because it's unlikely you'll ever find a person to talk to who can find this information out.

tedmiston 8y ago

I agree this is all a huge pain. I've been burned on "this test cost you x because of the facility it was done in and if you had gone to one of our partner labs (which you'd have no way of knowing without calling us), you could have had it done in <dedicated, partner lab> for 1/4x". I recently learned that there are 2 different codes involved and that it's the combination that matters. 1. The diagnostic code - the reason why you need that test 2. The procedure code - what the test is My insurance tells me that their coverage (as in whether they cover a service or do not) is different for the same procedure code with a different diagnostic code. I'm not sure if that implies that their coverage price for the same procedure code also varies by the diagnostic code. Your doctor can give you both codes for the test they're prescribing. In theory, your insurance company can tell you what they'll pay for the combination, and then you can contact each lab / hospital / service provider to get an estimate for what they'd bill. It's unclear how much recourse you have if the bill turns out to be significantly different than the estimate… that is once the bill actually arrives, sometimes 30–60 days later. I'm not sure if the service provider's bill varies for the same procedure code with a different diagnostic code. Admittedly this is all a huge pain and with my insurance company at least, cannot be done online, you must call and wait. It's all such a time sink that I usually just get the service done upfront and hope. Sometimes the end consumer cost is practically free, sometimes it's hundreds of dollars or more. It should be more feasible for us to know a rough estimate for a procedure across providers upfront.